Do We Need Alternative Screening Approaches for Cervical Cancer During Covid-19 Pandemic?

Abstract

health since it may allow the detection of not only precancerous lesions but also the cancers in their earliest stages, before the symptoms appear. However, the screening is not available for all types of cancer and has been highly recommended for cervical, breast, lung and colorectal cancers in certain ages and risk groups. Coronavirus disease 2019 (COVID-19) pandemic had a negative impact on cancer screening by making the access to preventive care facilities difficult. It has been stated that during COVID-19 pandemic between March and July 2020, particularly the women and individuals aged 30 to 49 years have postponed cancer screenings in Germany (1). Sharp decreases especially in the use of cervical cancer screening programs (2) may have led some cervical intraepithelial lesions to stay undetected in a potentially treatable stage of the cancerous progression. A two-month screening lock-down in Slovenia between March 12 and May 8, 2020 resulted in an 92% epidemic deficit of screening, as well as 70% and 68% decrease in follow-up and human papilloma virus (HPV) triage tests, respectively (3). During the stay-at-home order in California, approximately 80% decrease in cervical cancer screening rates compared with baseline was observed in the Kaiser Permanente Southern California (KPSC) network including 1.5 million women (4). National data in Italy showed that beside the lock-down, the significant reduction in the number of screening tests was also related to the fear of COVID-19, which resulted in the suspension of booked screenings and the reduction in adherence to screenings (5). The effects of disruption of cervical screening in COVID-19 pandemic can be mitigated by several approaches like HPV-based screening conducted from self-collected specimens. Such a reliable screening method may also allow to extend the screening intervals with longer reassurance against cervical cancer if it yields a negative result. The testing supported by telehealth Do We Need Alternative Screening Approaches for Cervical Cancer During Covid-19 Pandemic?